Traditional Chinese Medicine Neurology

Author: Xu Peihu
Publisher:
Publish Date: 1998-09-01
Features: The book is divided into four parts. The first part systematically elaborates on the development of Traditional Chinese Medicine (TCM) neurology, the etiology and pathogenesis of brain diseases, diagnostic and treatment methods, and modern research on commonly used TCM herbal formulas. The second part, organized by TCM disease names, introduces the differential diagnosis and treatment of 31 TCM brain diseases. The third part, organized by modern medical disease names, introduces the diagnosis, treatment, and latest research findings of 31 common brain diseases. The appendix includes a bibliography and formula index of TCM literature on brain diseases over the past decade for easy reference. The second and third parts are the core of the book, with a focus on TCM differentiation and treatment, Western medical treatment, and other therapeutic approaches. The book emphasizes clinical application, reflecting the new achievements and advancements in the diagnosis and treatment of brain diseases. It is suitable for clinical physicians, TCM college students and teachers, as well as practitioners of integrated Chinese and Western medicine.
Excerpt:
Chapter 1 The Basic System of TCM Neurology
TCM neurology is a discipline that systematically elaborates on the physiology and anatomy of the brain, the etiology and pathogenesis of brain diseases, the diagnosis, treatment, and rehabilitation of brain diseases, as well as brain health preservation, based on the fundamental theories of TCM. It is an important component of TCM.
1. The Main Content of TCM Neurology
The history of TCM neurology briefly introduces the understanding of TCM brain diseases by major physicians or works in history, their main viewpoints, and their contributions to the discipline, providing readers with a basic overview of its development and aiming to assist in reading historical literature.
The fundamental theories of TCM neurology include the physiology and anatomy of the brain, the etiology and pathogenesis of brain diseases, common diagnostic and differentiation methods, differential diagnosis of common symptoms, treatment of common syndromes, treatment principles and methods, as well as relevant content of pharmacology and formulaology.
The physiology and anatomy of the brain are the most fundamental content of TCM neurology. The physiological functions and characteristics of the brain and their relationships with the Zang-Fu organs and meridians are the foundation for understanding the etiology, pathogenesis, differentiation, treatment, rehabilitation, and prognosis of brain diseases, as well as for prevention and enhancing brain health.
The etiology and pathogenesis theory of brain diseases is of great importance for understanding and treating brain diseases. A correct understanding of the etiology and pathogenesis is the premise for proper treatment. Identifying the cause allows for targeted treatment to achieve a thorough cure.
The common etiologies of brain diseases mainly include Six Evils, epidemic qi, emotional disorders, congenital factors, diet, overexertion or rest, poisoning, trauma, phlegm-dampness, blood stasis, constitutional factors, and worm infestation.
Understanding the pathogenesis helps to grasp the patterns of disease occurrence and development, allowing for precise treatment to control the disease progression.
The common pathogenesis of brain diseases is often discussed from aspects such as deficiency of Zheng and excess of pathogen, excess of Zheng and pathogen, mixed deficiency and excess, involvement of other organs affecting the brain, and dysfunction of Qi, blood, body fluids, and meridians.
The diagnostic methods of brain diseases mainly include inspection, auscultation and olfaction, inquiry, and palpation—the four diagnostic methods. These methods are essential for collecting clinical data and obtaining information about the disease, forming the basis for accurate diagnosis. Therefore, the correctness and accuracy of the "Four Examinations" are crucial for the proper diagnosis and differentiation and treatment of the disease.
When applying the "Four Examinations," it is essential to always consider their combination and avoid substituting one for another, as each examination provides information from a different perspective. Only by combining them can a comprehensive and systematic understanding of the condition be achieved, leading to an accurate diagnosis.
In the diagnosis of brain diseases, the use of physical diagnostic methods (e.g., neurological examinations, consciousness tests, language tests, intelligence tests) and physicochemical diagnostic methods (e.g., X-ray diagnosis, electrical diagnosis, ultrasound diagnosis) are highly necessary and important diagnostic approaches for brain diseases, playing a significant role in accurate localization and prognosis assessment.
The differentiation of brain diseases includes various methods such as Eight Principles differentiation, Wei-Qi-Ying-Xue differentiation, San-Jiao differentiation, Qi-Blood-Jin-Ye differentiation, Zang-Fu differentiation, Meridian differentiation, and Etiology differentiation. These methods can be used individually or in combination.
Eight Principles differentiation is the foundation for other differentiation methods, playing a vital role in distinguishing the exterior/interior, cold/heat, deficiency/excess of syndromes, making it the most fundamental and important differentiation method.
The treatment principles of brain diseases are established based on differentiation. The main treatment principles include supporting Zheng and eliminating pathogen, adjusting Yin and Yang, treating exterior and interior, distinguishing primary and secondary syndromes, regulating Zang-Fu Qi and blood, and adhering to the principles of time, person, and place (San Yin).
Treatment methods are determined under the guidance of treatment principles. There are numerous treatment methods for brain diseases, which can be summarized as oral medication, external medication, acupuncture and moxibustion, massage, dietary therapy, psychological therapy, and symptomatic treatment. These methods can be used alone or in combination.
When determining treatment principles and methods, it is essential to comprehensively assess factors such as the patient's condition, disease progression, constitution, climate, etc. Additionally, the relationships between primary, secondary, and concurrent syndromes must be clarified, and all factors must be considered. It is also necessary to understand the indications and contraindications of various methods, achieving a balance between routine and flexible approaches ("method within method").
The selection of herbs and formulas for treating brain diseases must be guided by TCM theory, with a thorough understanding of the properties, flavors, meridian tropism, processing, functions, common dosages, and compatibility of herbs, as well as their special functions, fixed combinations, and special decoction methods. Modern pharmacological research should also be considered when selecting herbs. Formulas should be constructed according to established principles, but adjustments in herbs or dosages must be made, avoiding rigid adherence to standardized formulas.
TCM neurology is a highly practical clinical discipline whose theories originate from practice and constantly guide clinical practice. Therefore, this book focuses on clinical differentiation and treatment in the second and third parts.
In the second and third parts, the etiology, pathogenesis, diagnosis and differential diagnosis, differentiation and treatment, prognosis, rehabilitation, and research progress of common brain diseases are elaborated in detail.
1. Scope and Classification of Brain Diseases
Any disease caused by dysfunction of brain function or damage to brain tissue can be termed a brain disease.
According to etiology, brain diseases can be broadly classified into the following categories:
(1) Extrinsic Brain Diseases, including Spring Warmness, Summer Warmth, etc., which often have distinct seasonal characteristics and transmissibility, with symptoms such as fever, delirium, and convulsions.
(2) Intrinsic Brain Diseases, including stroke, headache, dizziness, tinnitus, epilepsy, mania, convulsions, depression, insomnia, hypersomnia, and infantile crying.
(3) Traumatic Brain Diseases refer to diseases caused by external force trauma or accidental needle injury leading to damage to brain tissue, with a clear history of trauma. The nature of mental disturbances may vary depending on the extent and location of brain tissue damage, ranging from no mental changes in mild cases to delirium in severe cases, but all may present with headache symptoms.
(4) Toxic Brain Diseases are caused by drug poisoning, food poisoning, environmental pollution, or toxic substances present in the geographical area entering the body through various pathways, with a clear history of poisoning and possible mental disturbances.
(5) Congenital Brain Diseases, including mental retardation and congenital cranial deformities, with significant congenital factors and symptoms such as mental disturbances, slow reaction, and dull expression.
(6) Other Causes of Brain Diseases, such as brain diseases caused by infection with tuberculosis worms or parasites residing in the brain, such as tuberculous encephalitis, cerebral cysticercosis, and cerebral schistosomiasis, which often present with headache.
In the above classification, the categorization of diseases is not absolute. For example, epilepsy can have congenital factors or traumatic causes, and headaches can be caused by external pathogens. Clinical analysis should be specific, avoiding rigid adherence.
Based on the presence or absence of clear mental disturbances, brain diseases can be broadly divided into two categories: those with clear mental disturbances, such as stroke, syncope, collapse, coma, epilepsy, mania, and delirium; and those without clear mental disturbances, such as dizziness and tinnitus.
Additionally, if classified according to Western medical disease names, the content and scope of brain diseases can be broadly summarized into three major categories:
(1) Neurological Diseases, such as cerebral hemorrhage, cerebral infarction, cerebral arteriosclerosis, encephalitis, brain tumors, brain trauma, hepatic degeneration, Parkinson's disease, epilepsy, and migraine.